Doctors increasingly prescribe time in nature to promote mental and physical health

Jun. 22—Combining greek prefix -bíos ("life") with suffix -philía ("friendship and affinity"), German physiologist Erich Fromm first coined the term biophilia in 1973: "the passionate love of life and of all that is alive."

The term has been more commonly adopted to mean, "the innate human instinct to connect with nature."

"There's a whole field of study called Biophilia," Brent Bauer, a doctor at Mayo Clinic in Rochester, said. "That means that we're wired to be connected to nature and those studies have actually proven time in nature can improve anxiety, blood pressure and concentration in children who have attention problems."

There has been a growing trend of doctors prescribing time in nature, or "park prescriptions" to their patients to improve mental and physical health.

"I'm a big believer," Bauer said. "I prescribe nature to my patients pretty frequently."

ParkRx is a program started in 2013 when the Institute at the Golden Gate, the National Recreation and Parks Association and National Park Service met with a group of health care practitioners to discuss recent findings that nature prescriptions improve mental and physical health.

This group ended up creating resources to support an emerging movement of park prescription practitioners. Since its founding, the number of park prescription programs has increased nationwide.

ParkRx took a 2020 census of 37 of these programs across the country and found that 24% of park prescriptions are issued with a specific health goal in mind while the other 78% are used to promote general wellness. The specific health goals are most often managing anxiety and depression or lower stress levels.

According to Bauer, written prescriptions enforce accountability and more effectively push patients to go outside than a verbal recommendation from their health care practitioner would.

"This actually takes it to another level," Bauer said. "I've seen a lot of people come back and say 'That's what got me back into going outdoors.'"

To test to see if it is the actual greenspace that brings about mental and physical health benefits or rather if just the exercise is beneficial, scientists conducted studies to see if someone who takes a walk through an urban setting sees the same health improvements as someone hiking through nature.

The 2015 study published in Proceedings of the National Academy of Science found that participants who went on the walk in nature saw lower levels of rumination, or negative thoughts about themselves, and had reduced brain activity in the area of the brain linked to mental illness than those who walked in an urban environment.

The researchers believe this suggests access to nature is "vital for mental health in our rapidly urbanizing world."

According to Bauer, there was another study conducted on the attention spans of children. There were three groups which each took a 90 minute walk: one group through nature, another through semi-urban areas and the last through a downtown setting.

"It turned out that in the urban area with the downtown area, the kids' attention was much shorter. When they got into nature, their attention improved." Bauer said. "Nature always wins."

For people who live in urban areas and might not have easy access to hiking trails or parks, there are a few things people can do to simulate being in nature that bring about similar benefits.

According to Bauer, playing videos or audio recordings of nature sounds can bring similar benefits to being outside.

"We did a study at Mayo a long time ago with nature sounds after surgery, so we had people who were going to be in the hospital (for) three, four days. Some of them just had a quiet relaxation period. Some listened to nature sounds," Bauer said. "Then we looked at who did better in terms of pain management and anxiety, and those who actually heard the recorded live nature sounds actually did statistically significantly better than those who just had the same period of time just being quiet."

While Bauer said this doesn't give the full benefits of being outside, it is a way to have some health improvements if it is not possible to get outside.

Other ways to simulate being in nature are to have natural elements in your work space, such as a picture of a waterfall or a wooden desk.

"You're going to have a little more productivity. You're going to have some better mental health outcomes," Bauer said. "I think there's a lot of ways to get this nature benefit."

The reason why being out in nature is so effective in bringing about good physical and mental health outcomes in the United States is because many of the health problems seen in its population are related to lifestyle and not getting enough exercise or outdoor time.

According to Bauer, a part of general health promotion comes from eating a better diet, getting more exercise and getting a higher quality of sleep. Bauer said he thinks that people should add getting enough time outdoors as a part of their general wellness routines.

"(Researchers) figured out that if you can get about 120 total minutes per week in nature, that seems to be about the sweet spot," Bauer said. "Obviously, more might be better, but if you say 'What would be the thing to shoot for?' I try and get my patients to be outside in nature for at least two hours every week."